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One Texas case shows why women can’t rely on legal exceptions to abortion bans

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Cox’s case speaks to the „hellish“ legal limbo these bans put patients, and providers, in.
The Texas Supreme Court has ruled against Kate Cox, a 31-year-old woman who sought an abortion in the state. Previously, Cox argued that the lethal condition impacting her fetus and health risks she’d face during the pregnancy meant she qualified for the exemptions outlined in Texas’s abortion ban. The court decision, which comes after Cox left Texas to obtain an abortion, sets a disturbing new precedent in a state that already has one of the most restrictive abortion bans in the country.
It’s a notable ruling because it further narrows what Texas law considers medical exceptions to its abortion ban, and could have implications for other states with similar policies. Currently, abortion is broadly banned in the state, and there are limited exceptions for conditions that endanger the life of the mother or that cause “substantial impairment” of bodily functions. Given how opaque the law is, it was not clear exactly what those exceptions entailed, and though the court didn’t explicitly clarify that ambiguity in its ruling, its decision suggests that health challenges like those Cox faced — including risks to future pregnancies — don’t qualify for the exemption.
“Some difficulties in pregnancy … even serious ones, do not pose the heightened risks to the mother the exception encompasses,” the court concluded, noting that Cox’s doctor hadn’t effectively affirmed that the complications she could face — including threats to future fertility — reached the threshold for an exception to the ban.
The justices also maintained existing uncertainty when it came to providers’ prerogative to conduct abortions in the state. Some providers have refrained from giving abortion care due to fear of legal consequences: Medical professionals found in violation of Texas’s abortion law can face up to 99 years in prison as well as large fines, while those who are found to have aided in providing abortion access can face civil suits.
The court ruled that the decision about whether a condition constituted a medical emergency, and thus qualified for an exemption, should be left up to physicians and not the courts. “Under the law, it is a doctor who must decide that a woman is suffering from a life-threatening condition during a pregnancy, raising the necessity for an abortion to save her life or to prevent impairment of a major bodily function,” the decision reads.

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